The first-ever national dementia strategy, intended to transform the care of the rising number of sufferers and their families, was launched by the government yesterday with funding of £150m and the promise of a string of memory clinics and advisors across the country.
But while the much-delayed strategy was welcomed by many in the field, it was criticised for failing to deliver on two crucial issues – research into the causes and potential treatments of dementia and the drugging of elderly people in care homes. A review of antipsychotic drugs – the so-called "chemical cosh" used in care homes to sedate people whose dementia makes them angry or distressed – has been postponed until the spring.
"This strategy is only the first step to tackling our dementia crisis, and it is a huge let-down that so much has been left out," said Rebecca Wood, chief executive of the Alzheimer's Research Trust.
"It is astonishing that dementia research is not a fundamental component of this strategy, and disappointing that the review of antipsychotic drugs has been delayed yet again," she added.
READ MORE @ GUARDIAN
Thursday, February 5, 2009
Wednesday, February 4, 2009
Common antidepressants cut adult suicide risk -study
Common antidepressants suspected of raising suicide risk among children reduce the risk for adults, Italian scientists reported on Monday.
The findings that the drugs cut suicide risk by more than 40 percent among adults and over 50 percent for elderly people should reassure doctors, the researchers said.
But the study confirmed the drugs seriously raise the suicide risk for children, Corrado Barbui of the University of Verona and colleagues reported in the Canadian Medical Journal.
READ MORE @ REUTERS
The findings that the drugs cut suicide risk by more than 40 percent among adults and over 50 percent for elderly people should reassure doctors, the researchers said.
But the study confirmed the drugs seriously raise the suicide risk for children, Corrado Barbui of the University of Verona and colleagues reported in the Canadian Medical Journal.
READ MORE @ REUTERS
Tuesday, February 3, 2009
Mental Illness Doesn't Predict Violent Behavior - Even when combined with substance abuse, psychiatric woes rank low as risk factor, study finds
Mental illness alone is not a predictor of future violent behavior, but mental illness combined with substance abuse or dependence does increase the risk, according to U.S. researchers who analyzed data collected from nearly 35,000 people.
People who have a severe mental illness but no substance abuse or a history of violence weren't any more likely than any other person in the general population to be violent over a period of three years, the study found. But the risk for future violence reached the level of statistical significance when mental illness was combined with substance abuse.
Still, the mental illness/substance abuse combination only ranked ninth on the study's list of the top 10 predictors of future violence. The predictors, listed from first to tenth, were: age (younger people are more likely to commit violence); history of violence; gender (males are more prone to violence); history of juvenile detention; divorce or separation in the past year; history of physical abuse; parental criminal history; unemployment in the past year; mental illness with substance abuse; and victimization in the past year.
RERAD MORE @ U.S. NEWS & WORLD REPORT
People who have a severe mental illness but no substance abuse or a history of violence weren't any more likely than any other person in the general population to be violent over a period of three years, the study found. But the risk for future violence reached the level of statistical significance when mental illness was combined with substance abuse.
Still, the mental illness/substance abuse combination only ranked ninth on the study's list of the top 10 predictors of future violence. The predictors, listed from first to tenth, were: age (younger people are more likely to commit violence); history of violence; gender (males are more prone to violence); history of juvenile detention; divorce or separation in the past year; history of physical abuse; parental criminal history; unemployment in the past year; mental illness with substance abuse; and victimization in the past year.
RERAD MORE @ U.S. NEWS & WORLD REPORT
Monday, February 2, 2009
Bipolar Disorder Linked to Higher Mortality from Medical Illnesses
Bipolar disorders appear to increase the risk of early death from a medical illness, according to a literature review study published as the lead article this week in the journal Psychiatric Services.
The researchers comprehensively reviewed 17 studies involving more than 331,000 patients. Evidence suggested that people with bipolar disorder have a higher mortality from natural causes compared to people in the general population of similar age and gender but without mental illness. The various studies indicated that the risk was from 35 percent to 200 percent higher. The risk is the same for men and women. The most common conditions leading to premature death were heart disease, respiratory diseases, stroke, and endocrine problems such as diabetes.
"The review of data gathered from large population studies suggests that having bipolar disorder is similar to being a smoker in terms of increasing a person's risk of early death," said Dr. Wayne Katon, a University of Washington (UW) professor of psychiatry. He co-authored the study with third-year UW psychiatry resident Babak Roshanaei-Moghaddam. The article is titled, "Premature Mortality from General Medical Illnesses Among Persons with Bipolar Disorder: A Review." Katon is a noted researcher on the interplay between life-shortening medical conditions and mood disorders.
People with bipolar disorder tend to have manic phases and depressed phases in their lives. During mania, they might be too wound up to sleep, their thoughts might race, and they might have boundless energy. During depression, they might feel painfully sad, hopeless, and immobilized.
READ MORE @ NEWSWISE
The researchers comprehensively reviewed 17 studies involving more than 331,000 patients. Evidence suggested that people with bipolar disorder have a higher mortality from natural causes compared to people in the general population of similar age and gender but without mental illness. The various studies indicated that the risk was from 35 percent to 200 percent higher. The risk is the same for men and women. The most common conditions leading to premature death were heart disease, respiratory diseases, stroke, and endocrine problems such as diabetes.
"The review of data gathered from large population studies suggests that having bipolar disorder is similar to being a smoker in terms of increasing a person's risk of early death," said Dr. Wayne Katon, a University of Washington (UW) professor of psychiatry. He co-authored the study with third-year UW psychiatry resident Babak Roshanaei-Moghaddam. The article is titled, "Premature Mortality from General Medical Illnesses Among Persons with Bipolar Disorder: A Review." Katon is a noted researcher on the interplay between life-shortening medical conditions and mood disorders.
People with bipolar disorder tend to have manic phases and depressed phases in their lives. During mania, they might be too wound up to sleep, their thoughts might race, and they might have boundless energy. During depression, they might feel painfully sad, hopeless, and immobilized.
READ MORE @ NEWSWISE
Sunday, February 1, 2009
Bitter Pill
Created to treat schizophrenia, Zyprexa wound up being used on misbehaving kids. How the pharmaceutical industry turned a flawed and dangerous drug into a $16 billion bonanza
In June 1992, not long after the place closed down, a Harvard-trained psychologist named Sergio Pirrotta walked out of Danvers State Hospital for the last time. The psychiatric facility, at this late date, was a baggy old thing, rectangled into a field just north of Boston; whole wings were barely occupied, and vandals had already begun to rip out the mantelpieces and furniture. The hospital had been slowly, incrementally shutting down for a decade, and the patients that remained were the hardest cases, mostly schizophrenics and those with disorders too dense and weird to classify. But now, as Pirrotta took a walk around the campus, even those patients were gone: released into the larger world to fend for themselves or bused to hospitals where the staffs had little psychiatric training.
Pirrotta had come to Danvers in the mid-1970s to rehabilitate children whom the courts had declared insane. Back then the place was overpopulated, the halls packed with madmen who would wander around smoking cigarettes, leering and lunging at the kids. In those days, the drugs used to treat mental illness were crude and ugly things. Thorazine was the best, and it made you into a ghouled and lifeless ogre — your face seized up involuntarily, you kept shuffling around, you were an emotional drone. But gradually the medications got a little bit better, the pharmacology more precise. First there was haloperidol, similar to Thorazine but with less-vivid side effects. Then clozapine, which had at first seemed a wonder drug, before it turned out to trigger a potentially fatal immune deficiency in two cases out of a hundred.
READ MORE @ ROLLING STONE
In June 1992, not long after the place closed down, a Harvard-trained psychologist named Sergio Pirrotta walked out of Danvers State Hospital for the last time. The psychiatric facility, at this late date, was a baggy old thing, rectangled into a field just north of Boston; whole wings were barely occupied, and vandals had already begun to rip out the mantelpieces and furniture. The hospital had been slowly, incrementally shutting down for a decade, and the patients that remained were the hardest cases, mostly schizophrenics and those with disorders too dense and weird to classify. But now, as Pirrotta took a walk around the campus, even those patients were gone: released into the larger world to fend for themselves or bused to hospitals where the staffs had little psychiatric training.
Pirrotta had come to Danvers in the mid-1970s to rehabilitate children whom the courts had declared insane. Back then the place was overpopulated, the halls packed with madmen who would wander around smoking cigarettes, leering and lunging at the kids. In those days, the drugs used to treat mental illness were crude and ugly things. Thorazine was the best, and it made you into a ghouled and lifeless ogre — your face seized up involuntarily, you kept shuffling around, you were an emotional drone. But gradually the medications got a little bit better, the pharmacology more precise. First there was haloperidol, similar to Thorazine but with less-vivid side effects. Then clozapine, which had at first seemed a wonder drug, before it turned out to trigger a potentially fatal immune deficiency in two cases out of a hundred.
READ MORE @ ROLLING STONE
Saturday, January 31, 2009
Women's mental health deteriorates as one in five experience common disorders
An NHS report has found a significant increase in the number of women suffering from depression, anxiety and suicidal thoughts
Women's mental health is deteriorating according to an NHS report that has found that more than one in five of the adult female population experiences depression, anxiety or suicidal thoughts.
The report found the proportion of women aged 16-64 with common mental disorders (CMDs) increased from 19.1% in 1993 to 21.5% in 2007, whereas the rate in men did not alter significantly.
The largest increase in CMD rates, up 20% between 1993 and 2007, was among women aged 45-64. The proportion of women aged 16-74 reporting suicidal thoughts also increased from 4.2% in 2000 to 5.5% in 2007.
Based on the results of a study of over 7,000 households carried out by the National Centre for Social Research together with researchers at the University of Leicester, the Adult Psychiatric Morbidity Survey is the latest in a series of surveys conducted at roughly seven-year intervals, with previous surveys carried out by the Office for National Statistics in 1993 and 2000.
READ MORE @ GUARDIAN
Women's mental health is deteriorating according to an NHS report that has found that more than one in five of the adult female population experiences depression, anxiety or suicidal thoughts.
The report found the proportion of women aged 16-64 with common mental disorders (CMDs) increased from 19.1% in 1993 to 21.5% in 2007, whereas the rate in men did not alter significantly.
The largest increase in CMD rates, up 20% between 1993 and 2007, was among women aged 45-64. The proportion of women aged 16-74 reporting suicidal thoughts also increased from 4.2% in 2000 to 5.5% in 2007.
Based on the results of a study of over 7,000 households carried out by the National Centre for Social Research together with researchers at the University of Leicester, the Adult Psychiatric Morbidity Survey is the latest in a series of surveys conducted at roughly seven-year intervals, with previous surveys carried out by the Office for National Statistics in 1993 and 2000.
READ MORE @ GUARDIAN
Friday, January 30, 2009
Which antidepressants are most effective?
The glut of antidepressant drugs on the market and the ads for them may have you – not to mention doctors – wondering how to tell one from the other. But a new study sheds light on which ones may be most effective in battling the blues.
Topping the list of a dozen prescription antidepressants reviewed: Zoloft and Lexapro. Patients taking those drugs in trials were also the least likely to drop out. But because Zoloft, made by New York-based Pfizer, is now off patent and available in relatively cheap, generic form, it may be the better choice for patients starting antidepressant therapy, write authors of the study published today in The Lancet, who are from Italy, Greece, England and Japan.
READ MORE @ SCIENTIFIC AMERICAN
Topping the list of a dozen prescription antidepressants reviewed: Zoloft and Lexapro. Patients taking those drugs in trials were also the least likely to drop out. But because Zoloft, made by New York-based Pfizer, is now off patent and available in relatively cheap, generic form, it may be the better choice for patients starting antidepressant therapy, write authors of the study published today in The Lancet, who are from Italy, Greece, England and Japan.
READ MORE @ SCIENTIFIC AMERICAN
Thursday, January 29, 2009
Adoption and Mental Illness
Does adoption pose psychological risks? University of Minnesota researchers revisited this controversial issue recently and found that common DSM-IV childhood disorders are more prevalent in adoptees than nonadoptees.1 They also found that adoptees are more likely to have contact with mental health professionals.
The mental health of adoptees has become an increasingly important issue as the number of adoptions in the United States continues to rise. According to the National Council For Adoption,1 there were 130,269 domestic adoptions and 21,063 intercountry adoptions in 2002. (In 1996 there were 108,463 domestic adoptions and 11,303 intercountry adoptions.) US Census figures in 2000 indicated that nearly 1.6 million children and teenagers under 18 years in the US and Puerto Rico are adopted.2
The adoption study compared a random sample of 540 adolescents born in Minnesota, who were not adopted, with a representative sample of adoptees (514 international adoptees and 178 domestic adoptees). The children had been placed by the 3 largest adoption agencies in Minnesota.3
“All of the kids were adopted within the first 2 years of life, but the great majority were adopted within the first year,” said Margaret A. Keyes, PhD, lead author of the study and a research psychologist. “The average age at placement was 4 months. So it is not as if you are looking at 3- and 4-year-olds coming over on a plane from a faraway country.”
READ MORE @ PSYCHIATRIC TIMES
The mental health of adoptees has become an increasingly important issue as the number of adoptions in the United States continues to rise. According to the National Council For Adoption,1 there were 130,269 domestic adoptions and 21,063 intercountry adoptions in 2002. (In 1996 there were 108,463 domestic adoptions and 11,303 intercountry adoptions.) US Census figures in 2000 indicated that nearly 1.6 million children and teenagers under 18 years in the US and Puerto Rico are adopted.2
The adoption study compared a random sample of 540 adolescents born in Minnesota, who were not adopted, with a representative sample of adoptees (514 international adoptees and 178 domestic adoptees). The children had been placed by the 3 largest adoption agencies in Minnesota.3
“All of the kids were adopted within the first 2 years of life, but the great majority were adopted within the first year,” said Margaret A. Keyes, PhD, lead author of the study and a research psychologist. “The average age at placement was 4 months. So it is not as if you are looking at 3- and 4-year-olds coming over on a plane from a faraway country.”
READ MORE @ PSYCHIATRIC TIMES
Wednesday, January 28, 2009
Most Second-Generation Antipsychotics Effective for Treatment of Negative Schizophrenia Symptoms: Presented at EPA
Amisulpride and ziprasidone show better overall effects in comparison with other second-generation antipsychotics in the of negative symptoms of schizophrenia, according to results of 2 meta-analyses of randomised controlled trials.
Principal investigator Javier Rejas, MD, PhD, Medical Unit, Health Outcomes Research, Pfizer España, Madrid, Spain, presented these results on January 27 here at the 17th European Congress of Psychiatry, organised by the European Psychiatric Association (EPA).
While research has demonstrated the efficacy of numerous first-generation antipsychotics, such as haloperidol, for treatment of positive symptoms of schizophrenia, negative symptoms are difficult to treat and can result in severe impairment and poor quality of life, said Dr. Rejas.
His research team therefore conducted 2 meta-analyses to compare the efficacy of second-generation antipsychotics versus haloperidol and versus placebo in the treatment of negative schizophrenia symptoms.
READ MORE @ DOCTOR'S GUIDE
Principal investigator Javier Rejas, MD, PhD, Medical Unit, Health Outcomes Research, Pfizer España, Madrid, Spain, presented these results on January 27 here at the 17th European Congress of Psychiatry, organised by the European Psychiatric Association (EPA).
While research has demonstrated the efficacy of numerous first-generation antipsychotics, such as haloperidol, for treatment of positive symptoms of schizophrenia, negative symptoms are difficult to treat and can result in severe impairment and poor quality of life, said Dr. Rejas.
His research team therefore conducted 2 meta-analyses to compare the efficacy of second-generation antipsychotics versus haloperidol and versus placebo in the treatment of negative schizophrenia symptoms.
READ MORE @ DOCTOR'S GUIDE
Tuesday, January 27, 2009
Obama battles big pharma
Pfizer's latest mega deal reflects the threats faced by global drugs firms, not least from the new US president, says Alistair Dawber
"We will lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programmes and taking on drug companies that block cheaper generic medicines from the market." The wording of President Obama's healthcare policy could not be clearer and should send a shiver through the boardroom of every major pharmaceutical group in the world.
For some time, the big players in the drugs market have faced a simple problem. Treatments that the likes of Pfizer, Novartis and GlaxoSmithKline (GSK) have spent years and millions of dollars developing are increasingly coming under threat from the generics companies, which invest nearly as much energy in challenging patents and developing cheaper alternatives. The established groups may consider the generics firms parasitical, but the likes of Barack Obama and the European Commission are tiring of the big beasts hiding behind patents ensuring that healthcare is more expensive to the ultimate user.
The European Commission said in November that the pharmaceutical groups are blocking the entry of new, cheaper drugs on to the market and that this cost EU healthcare providers, including the National Health Service, an estimated €3bn between 2000 and 2007. It added that it "will not hesitate to open antitrust cases against companies where there are indications that the antitrust rules may have been breached."
READ MORE @ INDEPENDENT
"We will lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programmes and taking on drug companies that block cheaper generic medicines from the market." The wording of President Obama's healthcare policy could not be clearer and should send a shiver through the boardroom of every major pharmaceutical group in the world.
For some time, the big players in the drugs market have faced a simple problem. Treatments that the likes of Pfizer, Novartis and GlaxoSmithKline (GSK) have spent years and millions of dollars developing are increasingly coming under threat from the generics companies, which invest nearly as much energy in challenging patents and developing cheaper alternatives. The established groups may consider the generics firms parasitical, but the likes of Barack Obama and the European Commission are tiring of the big beasts hiding behind patents ensuring that healthcare is more expensive to the ultimate user.
The European Commission said in November that the pharmaceutical groups are blocking the entry of new, cheaper drugs on to the market and that this cost EU healthcare providers, including the National Health Service, an estimated €3bn between 2000 and 2007. It added that it "will not hesitate to open antitrust cases against companies where there are indications that the antitrust rules may have been breached."
READ MORE @ INDEPENDENT
Monday, January 26, 2009
Hallucinations Are Rare Side Effects of ADHD Medications
Children who take medications for attention-deficit hyperactivity disorder (ADHD) may rarely experience some disturbing side effects, such as hallucinations.
U.S. government experts reviewed clinical trials and post-marketing reports of side effects from the commonly prescribed ADHD stimulant medications, such as Concerta, Ritalin and Strattera. They found that out of every 100 "person-years" of treatment, one or two children will experience serious side effects, such as hallucinations of bugs or snakes.
"Patients and physicians should be aware that psychosis or mania arising during drug treatment of attention-deficit hyperactivity disorder may represent adverse drug reactions, the study's authors wrote in the February issue Pediatrics.
READ MORE @ WASHINGTON POST
U.S. government experts reviewed clinical trials and post-marketing reports of side effects from the commonly prescribed ADHD stimulant medications, such as Concerta, Ritalin and Strattera. They found that out of every 100 "person-years" of treatment, one or two children will experience serious side effects, such as hallucinations of bugs or snakes.
"Patients and physicians should be aware that psychosis or mania arising during drug treatment of attention-deficit hyperactivity disorder may represent adverse drug reactions, the study's authors wrote in the February issue Pediatrics.
READ MORE @ WASHINGTON POST
Sunday, January 25, 2009
Sex and Depression: In the Brain, if Not the Mind
As everyone knows, sex feels good.
Or does it? In recent years, I’ve come across several patients for whom sex is not just unpleasurable; it actually seems to cause harm.
One patient, a young man in his mid-20s, described it this way: “After sex, I feel literally achy and depressed for about a day.”
Otherwise, he had a clean bill of health, both medical and psychiatric: well adjusted, hard-working, lots of friends and a close-knit family.
Believe me, I could have cooked up an explanation very easily. He had hidden conflicts about sex, or he had ambivalent feelings about his partner. Who doesn’t?
But search as I could for a good explanation, I could find none. Though his symptoms and distress were quite real, I told him he did not have a major psychiatric problem that required treatment. He was clearly disappointed leaving my office.
READ MORE @ NY TIMES
Or does it? In recent years, I’ve come across several patients for whom sex is not just unpleasurable; it actually seems to cause harm.
One patient, a young man in his mid-20s, described it this way: “After sex, I feel literally achy and depressed for about a day.”
Otherwise, he had a clean bill of health, both medical and psychiatric: well adjusted, hard-working, lots of friends and a close-knit family.
Believe me, I could have cooked up an explanation very easily. He had hidden conflicts about sex, or he had ambivalent feelings about his partner. Who doesn’t?
But search as I could for a good explanation, I could find none. Though his symptoms and distress were quite real, I told him he did not have a major psychiatric problem that required treatment. He was clearly disappointed leaving my office.
READ MORE @ NY TIMES
Saturday, January 24, 2009
Pfizer said to be in talks to buy Wyeth
Pfizer's discussions to acquire Wyeth, the drug company that makes the antidepressant Effexor, have advanced, bringing the two pharmaceuticals giants closer to a potential merger, people briefed on the matter said Friday.
While no agreement had been reached, it was possible that a deal for Pfizer to buy Wyeth could be announced within days, said these people. Such a deal could be worth $60 billion or more, analysts say.
The merger would be popular among investors and analysts who have been pushing Pfizer to make a bold move. The drug maker has been struggling with flat revenue, diminishing returns on research and looming generic competition to Lipitor, the world's top-selling drug.
READ MORE @ INTERNATIONAL HERALD TRIBUNE
While no agreement had been reached, it was possible that a deal for Pfizer to buy Wyeth could be announced within days, said these people. Such a deal could be worth $60 billion or more, analysts say.
The merger would be popular among investors and analysts who have been pushing Pfizer to make a bold move. The drug maker has been struggling with flat revenue, diminishing returns on research and looming generic competition to Lipitor, the world's top-selling drug.
READ MORE @ INTERNATIONAL HERALD TRIBUNE
Friday, January 23, 2009
More Americans Skipping Necessary Prescriptions, Survey Finds
One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.
That figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.
The current figure may be even higher because of the recent economic downturn, said Laurie E. Felland, a senior health researcher at the center and lead author of the study.
“Our findings are particularly troublesome given the increased reliance on prescription drugs to treat chronic conditions,” she added. “People who go without their prescriptions experience worsening health and complications.”
The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.
READ MORE @ NY TIMES
That figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.
The current figure may be even higher because of the recent economic downturn, said Laurie E. Felland, a senior health researcher at the center and lead author of the study.
“Our findings are particularly troublesome given the increased reliance on prescription drugs to treat chronic conditions,” she added. “People who go without their prescriptions experience worsening health and complications.”
The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.
READ MORE @ NY TIMES
Thursday, January 22, 2009
People With Schizophrenia Say Bias Is Part of Their Lives
People with schizophrenia often expect to be discriminated against, and are, in various aspects of their life, new research finds.
The study, which included 732 people with schizophrenia in the United States and 26 other countries, found that 47 percent reported discrimination in making or keeping friends, 43 percent from family members, and 27 percent in intimate or sexual relationships. Also, 29 percent of the participants said they experienced discrimination while trying to find or keep a job.
What the study referred to as positive discrimination was reported by less than 5 percent of the participants.
The researchers also found that 64 percent of the participants didn't bother applying for work, training or education because they expected to fail or to face discrimination, and 55 percent anticipated discrimination when seeking a close relationship. However, more than a third of participants who expected these types of discrimination did not actually experience it.
READ MORE @ WASHINGTON POST
The study, which included 732 people with schizophrenia in the United States and 26 other countries, found that 47 percent reported discrimination in making or keeping friends, 43 percent from family members, and 27 percent in intimate or sexual relationships. Also, 29 percent of the participants said they experienced discrimination while trying to find or keep a job.
What the study referred to as positive discrimination was reported by less than 5 percent of the participants.
The researchers also found that 64 percent of the participants didn't bother applying for work, training or education because they expected to fail or to face discrimination, and 55 percent anticipated discrimination when seeking a close relationship. However, more than a third of participants who expected these types of discrimination did not actually experience it.
READ MORE @ WASHINGTON POST
Wednesday, January 21, 2009
Antidepressant Has Modest Benefits in Anxious Older Patients
Treating generalized anxiety disorder in patients 60 and older with a selective serotinin reuptake inhibitor (SSRI) significantly improved their symptoms as long as they took the drug, researchers here said.
The response rate among patients taking escitalopram (Lexapro) for up to 12 weeks was 69%, compared with 51% assigned to placebo in a randomized trial (P=0.03), reported Eric J. Lenze, M.D., of Washington University, and colleagues in the Jan. 21 issue of the Journal of the American Medical Association.
There were significantly greater improvements with the active drug versus placebo for activity limitations, social function, worry questionnaire scores, and overall anxiety symptoms and role functioning, the researchers said.
But the researchers characterized the improvements in the 179-patient trial as "modest," and diminished further by nonadherence.
READ MORE @ MEDPAGE TODAY
The response rate among patients taking escitalopram (Lexapro) for up to 12 weeks was 69%, compared with 51% assigned to placebo in a randomized trial (P=0.03), reported Eric J. Lenze, M.D., of Washington University, and colleagues in the Jan. 21 issue of the Journal of the American Medical Association.
There were significantly greater improvements with the active drug versus placebo for activity limitations, social function, worry questionnaire scores, and overall anxiety symptoms and role functioning, the researchers said.
But the researchers characterized the improvements in the 179-patient trial as "modest," and diminished further by nonadherence.
READ MORE @ MEDPAGE TODAY
Tuesday, January 20, 2009
ADHD Medication: Can Your Child Go Without? Behavioral therapy for ADHD—and parent retraining, too—can be good alternatives to medication
Attention deficit hyperactivity disorder can be a distressing diagnosis, but families have more treatment options than they might realize. Although Ritalin and other stimulant drugs are the most common prescription, ADHD treatments that don't involve medication have a proven track record. And here's a surprise: One of the most beneficial options treats the parents, not the child. For children, skills training programs and ADHD summer camps can help teach techniques to overcome everyday problems that often make life miserable, such as remembering to bring assignments home from school or to listen without interrupting.
How training parents helps the child. Parent skills training has been used for years to improve the behavior of children, and multiple clinical trials have validated its effectiveness. Those same programs improve the behavior of kids with ADHD. Although it may seem odd to be changing parents' behavior to treat what's considered a medical condition in children, research has found that for children with ADHD, having parents who use effective parenting techniques is one of the best predictors of success in adulthood. These programs teach parents to make clear, specific requests of children, for instance, and to use praise and rewards for good behavior far more often than punishment.
READ MORE @ U.S. NEWS & WORLD REPORT
How training parents helps the child. Parent skills training has been used for years to improve the behavior of children, and multiple clinical trials have validated its effectiveness. Those same programs improve the behavior of kids with ADHD. Although it may seem odd to be changing parents' behavior to treat what's considered a medical condition in children, research has found that for children with ADHD, having parents who use effective parenting techniques is one of the best predictors of success in adulthood. These programs teach parents to make clear, specific requests of children, for instance, and to use praise and rewards for good behavior far more often than punishment.
READ MORE @ U.S. NEWS & WORLD REPORT
Monday, January 19, 2009
New study: Bipolar disorder and schizophrenia are genetically linked
A new study suggests that if schizophrenia runs in a family, there's a good chance that bipolar disorder does as well (and vice versa). The findings, published today in the journal The Lancet, suggest that the two disorders are caused by some of the same genes.
"These findings say that [schizophrenia and bipolar disorder] are related, above all, for genetic reasons," says lead study author Paul Lichtenstein, a genetic epidemiologist at the Karolinska Institutet in Stockholm, Sweden. "[Therefore] it might not be a good idea to view these disorders as separate entities."
Lichtenstein and his colleagues (researchers from both the U.S. and Sweden) scoured the entire Swedish population for anyone with schizophrenia or bipolar disorder by reviewing psychiatric discharge data from all Swedish hospitals between 1973 and 2004.
READ MORE @ SCIENTIFIC AMERICAN
"These findings say that [schizophrenia and bipolar disorder] are related, above all, for genetic reasons," says lead study author Paul Lichtenstein, a genetic epidemiologist at the Karolinska Institutet in Stockholm, Sweden. "[Therefore] it might not be a good idea to view these disorders as separate entities."
Lichtenstein and his colleagues (researchers from both the U.S. and Sweden) scoured the entire Swedish population for anyone with schizophrenia or bipolar disorder by reviewing psychiatric discharge data from all Swedish hospitals between 1973 and 2004.
READ MORE @ SCIENTIFIC AMERICAN
Sunday, January 18, 2009
No Long-Term Harm From Short-Term Placebo in Adolescent Depression Trials
Delaying active therapy for teens with major depression didn't impair long-term outcomes in the context of a clinical trial.
Patients on placebo for 12 weeks before switching to antidepressants or cognitive behavioral therapy showed no difference in 36-week response rate (82% versus 83%) compared with those on active treatment from the start of a large randomized trial, said Betsy D. Kennard, Psy.D., of the University of Texas Southwestern Medical Center at Dallas, and colleagues.
The 12-week delay in active therapy also had little impact on rates of suicidal events and symptom worsening, the researchers reported online in the American Journal of Psychiatry.
Although these findings support placebo treatment as an ethical course of action in a well-run pediatric clinical trial, Dr. Kennard emphasized that its use was not simply a matter of "wait and see" if a teen gets better.
READ MORE @ MEDPAGE TODAY
Patients on placebo for 12 weeks before switching to antidepressants or cognitive behavioral therapy showed no difference in 36-week response rate (82% versus 83%) compared with those on active treatment from the start of a large randomized trial, said Betsy D. Kennard, Psy.D., of the University of Texas Southwestern Medical Center at Dallas, and colleagues.
The 12-week delay in active therapy also had little impact on rates of suicidal events and symptom worsening, the researchers reported online in the American Journal of Psychiatry.
Although these findings support placebo treatment as an ethical course of action in a well-run pediatric clinical trial, Dr. Kennard emphasized that its use was not simply a matter of "wait and see" if a teen gets better.
READ MORE @ MEDPAGE TODAY
Friday, January 16, 2009
Study Finds Drug Risks With Newer Antipsychotics
The popular drugs known as atypical antipsychotics, prescribed for an array of conditions, including schizophrenia, autism and dementia, double patients’ risk of dying from sudden heart failure, a study has found.
The finding is the latest in a succession of recent reports contradicting the long-held assumption that the new drugs, which include Risperdal, Zyprexa and Seroquel, are safer than the older and much less expensive medications that they replaced.
The risk of death from the drugs is not high, on average about 3 percent in a person being treated at least 10 years, according to the study, published Thursday in The New England Journal of Medicine. Nor was the risk different from that of the older antipsychotic drugs.
But it was significant enough that an accompanying editorial urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients,who can be highly susceptible to the drugs’ side effects, including rapid weight gain.
READ MORE @ NY TIMES
The finding is the latest in a succession of recent reports contradicting the long-held assumption that the new drugs, which include Risperdal, Zyprexa and Seroquel, are safer than the older and much less expensive medications that they replaced.
The risk of death from the drugs is not high, on average about 3 percent in a person being treated at least 10 years, according to the study, published Thursday in The New England Journal of Medicine. Nor was the risk different from that of the older antipsychotic drugs.
But it was significant enough that an accompanying editorial urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients,who can be highly susceptible to the drugs’ side effects, including rapid weight gain.
READ MORE @ NY TIMES
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